1 rich Libsyn https://www.libsyn.com 90 600 Contributor: Don Stader, MD Educational Pearls: The classic migraine cocktail includes: Reglan (or other dopamine antagonist), Benadryl, Toradol, Decadron, and IV fluids.&amp;nbsp; The most effective agent in the cocktail is a dopaminergic agent&amp;nbsp; Routine IV fluids have not shown efficacy&amp;nbsp; There is no evidence for pre-treatment of akathisia with diphenhydramine (Benadryl) Decadron reduces rebound headache&amp;nbsp; Consider trigger point injections for those with migraine attributable to cervical neck pain.&amp;nbsp; References Jones CW, Remboski LB, Freeze B, Braz VA, Gaughan JP, McLean SA..Intravenous Fluid for the Treatment of Emergency Department Patients With Migraine Headache: A Randomized Controlled Trial.&amp;nbsp; Ann Emerg Med. 2019 Feb;73(2):150-156. doi: 10.1016/j.annemergmed.2018.09.004. Epub 2018 Oct 26. Friedman BW, Cabral L, Adewunmi V, et al. Diphenhydramine as Adjuvant Therapy for Acute Migraine: An Emergency Department-Based Randomized Clinical Trial. Ann Emerg Med. 2016;67(1):32–39.e3. doi:10.1016/j.annemergmed.2015.07.495 Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD Emergency Medical Minute https://www.emergencymedicalminute.com <iframe title="Libsyn Player" style="border: none" src="//html5-player.libsyn.com/embed/episode/id/12714677/height/90/theme/custom/thumbnail/yes/direction/forward/render-playlist/no/custom-color/fa102a/" height="90" width="600" scrolling="no" allowfullscreen webkitallowfullscreen mozallowfullscreen oallowfullscreen msallowfullscreen></iframe> https://assets.libsyn.com/secure/content/62258864